Transcystic access of the common bile duct in a patient with a type III choledochal cyst (choledochocele) and cystolithiasis

2015 ◽  
Vol 81 (5) ◽  
pp. 1264
Author(s):  
Nicolas Villa ◽  
Isaac Raijman
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Type Iii ◽  
The Common

scholarly journals Endoscopic treatment of choledochal cyst type III

2008 ◽  
Vol 21 (3) ◽  
pp. 139-141 ◽  
Author(s):  
Matheus Alessi Rodrigues ◽  
Alexandre Venâncio de Sousa ◽  
Ciro Falcone ◽  
Gabriel Coelho ◽  
Durval Knox da Veiga ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Endoscopic Treatment ◽  
Recurrent Abdominal Pain ◽  
Common Disease ◽  
Endoscopic Drainage ◽  
Type Iii ◽  
Cyst Type ◽  
The Common

BACKGROUND: Todani type III cysts are not very common disease. Endoscopically the choledochocele is not a challenging diagnosis. Sometimes biliary stone disease is associated and events of cholangitis and pancreatitis may occur. Normally these patients are referred for surgical treatment, mainly because there is a widespread concept that choledocal cysts are very prone to develop neoplasia and must be resected. Nevertheless surgical resection is not free of morbidity. The chance for neoplasia in such cases seems to be related to the presence of pancreaticobiliary reflux towards the common bile duct. AIM: To report a case of endoscopic treatment of choledochal cyst type III with literature review. CASE REPORT: Young man with recurrent abdominal pain, fever and hyperamylasemia. An ERCP showed pancreaticobiliary maljunction and calculus impaction. Papillotomy was performed and complete biliary clearance was achieved. Amylase contents in the common bile duct was measured and normal. Due to absence of pancreatiobiliary reflux, a second endoscopic approach was performed and a wide communication between choledochocele and duodenum was done with diathermy (using the papillotome). The patient recovering was uneventful and in 30 months follow-up he remains asymptomatic. CONCLUSION: Since pancreatobiliary reflux is not present, surgical approach of the diverticulum seemed to be not necessary. Endoscopic drainage of choledococele was a good option for conservative treatment.

scholarly journals Case Report: Isolated Cystic Dilatation of the Cystic Duct: A Misdiagnosed Case Preoperatively

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiankang Zhang ◽  
Zeming Hu ◽  
Xuan Lin ◽  
Dongliang Zhang ◽  
Hao Wang ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Extrahepatic Bile Duct ◽  
Cystic Dilatation ◽  
Liver Transaminase ◽  
Caudal Portion ◽  
The Common

A 33-year-old female with a mild elevation of liver transaminase was sent to the general surgery department for medical services due to upper-right abdominal pain for 2 weeks. A liquid dark area ~4 × 3 × 3 cm in size in the theoretical location of the pancreatic segment of the common bile duct was detected by abdominal CT with no enhancement of the cystic wall found in the enhanced CT scan. The patient was then diagnosed with a choledochal cyst based on the results of the radiological images preoperatively. During the operation, the isolated cystic dilatation was found in the middle part of the cystic duct, and its caudal portion was found behind the head of the pancreas and converged into the common bile duct at an acute angle and low insertion. According to the intraoperative evaluation, the female was then diagnosed with a cystic duct cyst (CDC). The surgery was converted to a laparotomy for the unclear structure and the possibility of anatomic variation of the bile duct. The caudal portion of the cystic duct was found communicated with the common bile duct with a narrow base, and the extrahepatic bile duct was not cystic. The CDC was removed in the surgery. One week later, the patient was discharged from the hospital for the disappearance of abdominal pain and normal liver transaminase and did not report any discomfort in the 1-month-long follow-up. The lessons drawn from this case were as follows: (1) the distinction between the relatively frequent choledochal cyst and the isolated CDC should always be taken in mind; (2) a surgical strategy should be given priority for an intraoperatively confirmed CDC; (3) a common bile duct exploration is recommended for patients with choledocholithiasis or jaundice.

Embryonal rhabdomyosarcoma of the common bile duct mimicking choledochal cyst

2005 ◽  
Vol 12 (3) ◽  
pp. 263-265 ◽  
Author(s):  
Gulay A. Tireli ◽  
Serdar Sander ◽  
Sergulen Dervisoglu ◽  
Oyhan Demirali ◽  
Murat Unal
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Embryonal Rhabdomyosarcoma ◽  
The Common

Choledochal cyst with secondary cholangitis, choledochitis, duodenal papillitis, and pancreatitis in a young domestic shorthair cat

2021 ◽  
pp. 104063872110171
Author(s):  
Megan E. Schreeg ◽  
Sybille A. Miller ◽  
John M. Cullen
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Duodenal Papilla ◽  
Choledochal Cysts ◽  
Chronic Antigenic Stimulation ◽  
Bile Drainage ◽  
Biliary Ducts ◽  
The Common ◽  
Duodenal Papillitis

Choledochal cysts, congenital segmental dilations of the common bile duct, have been reported in few cats, and histologic characterization is lacking. A 20-mo-old spayed female domestic shorthair cat was presented because of vomiting and weight loss. There was progressive elevation of liver enzyme activity (ALT > ALP, GGT) and hyperbilirubinemia. Diagnostic imaging identified focal cystic dilation of the common bile duct, dilation and tortuosity of adjacent hepatic ducts, and a prominent duodenal papilla. A choledochal cyst was suspected, and the animal was euthanized. On postmortem examination, there was a 2-cm, firm, thickened, cystic dilation of the common bile duct, patent with adjacent ducts. Histologically, the cyst wall was expanded by fibroblasts, collagen, and lymphoplasmacytic inflammation. Adjacent bile ducts were markedly dilated and tortuous, with lymphoplasmacytic inflammation and papillary mucosal hyperplasia that extended to the major duodenal papilla. There was chronic neutrophilic cholangitis, suggesting bacterial infection and/or disturbed bile drainage, extrahepatic obstruction, and lymphoplasmacytic pancreatitis with ductular metaplasia. Prominent lymphoid follicles within biliary ducts and duodenum suggested chronic antigenic stimulation. Choledochal cysts can be associated with chronic neutrophilic cholangitis, extrahepatic obstruction, choledochitis, duodenal papillitis, and pancreatitis, and should be a differential for increased hepatic enzymes and hyperbilirubinemia in young cats.

Laparoscopic surgery for lithiasis local choledochal dilatation diagnosed a cyst: Case report and literature reviews

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Tuấn Anh Đỗ ◽  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Frozen Section ◽  
Extrahepatic Bile Duct ◽  
Intrahepatic Bile Duct ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Proper Diagnosis ◽  
The Common

Abstract Biliary dilation is common in clinical practice and originates from many pathologies; among them, choledocholithiasis, chronic pancreatitis and periampullary diverticula (PAD) are the most common. Popular signs of cholelithiasis is diffuse dilatation of the intra- and extrahepatic bile duct, however, in some cases, it might be local dilatation of the common bile duct without intrahepatic bile duct dilatation. The long-term outcome is favorable, however, it is necessary to rule out other causes such as choledochal cyst, pancreatitis by frozen section in order to have a proper diagnosis and treatment. We describe a 19-year-old female patient with local dilation of the common bile duct due to choledocholithiasis that was operated laparoscopically with success. Key word: Local common bile duct dilation, gallstones, choledochal cyst, laparoscopy. Tóm tắt Giãn đường mật là một hình thái tổn thương hay gặp trên lâm sàng, do nhiều bệnh lý khác nhau, hay gặp nhất là sỏi ống mật chủ (OMC), viêm tụy mạn và túi thừa Vater 1. Dấu hiệu phổ biến của sỏi mật là giãn đường mật trong và ngoài gan lan tỏa, tuy nhiên có trường hợp OMC giãn đơn thuần không kèm theo giãn đường mật trong gan. Tiên lượng của bệnh này là tốt, tuy nhiên cần loại trừ các nguyên nhân như nang OMC, viêm tụy bằng sinh thiết tức thì để có chẩn đoán và điều trị phù hợp nhất. Chúng tôi xin báo cáo một trường hợp người bệnh (NB) nữ, 19 tuổi mắc sỏi mật gây giãn OMC khu trú dạng nang được phẫu thuật nội soi thành công. Từ khóa: Giãn đường mật khu trú, sỏi mật, nang ống mật chủ, phẫu thuật nội soi.

scholarly journals Cystic Dilatations of the Common Bile Duct in Adults

HPB Surgery ◽  
1996 ◽  
Vol 10 (2) ◽  
pp. 91-95 ◽  
Author(s):  
Gr. Kouraklis ◽  
E. Misiakos ◽  
A. Glinavou ◽  
G. Karatzas ◽  
J. Gogas ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Good Health ◽  
Type I ◽  
Cyst Excision ◽  
Type Iii ◽  
Long Term Follow Up ◽  
Risk Of Malignancy ◽  
The Common ◽  
Age Range

Cystic dilatations of the common bile duct are believed to be of congenital etiology with most cases presenting in childhood. During the last 20 years, 10 patients with cystic dilatations of the bile duct were treated in our Department. There were 5 men and 5 women with an age range of 35–81 years. Clinical presentation consisted of right hypohondrial pain, nausea, vomiting and a history of obstructive jaundice. Diagnosis was established by ultrasound, cholangiography and ERCP in most cases. According to the Todani classification system, 5 patients had type I cysts, 4 had type II and one had type III. At the time of surgery, main associated diseases were choledocholithiasis in 3 cases and cholangitis in 2 cases. One patient (type III) underwent endoscopic sphincterotomy; 4 patients underwent internal drainage and 2 of them developed mild cholangitis postoperatively; 5 patients underwent excision of the cyst and a biliary-enteric bypass and developed no main complications. Patients remained in good health during long-term follow-up. We conclude that cyst excision is the treatment ofchoice for adults in order to reduce postoperative morbidity and the potential risk of malignancy.

scholarly journals Gall Bladder Tumour, Choledochal Cyst and an Anomalous Pancreatico-Biliary Junction

HPB Surgery ◽  
1995 ◽  
Vol 8 (3) ◽  
pp. 185-186 ◽  
Author(s):  
T. F. Toufeeq Khan ◽  
Zaheer A. Sherazi ◽  
Yan Yew Tan
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Gall Bladder ◽  
Choledochal Cyst ◽  
Bladder Tumour ◽  
Bladder Carcinogenesis ◽  
The Common

This report highlights the association of a tumour in an acalculous gall bladder with an anomalous pancreatico-biliary junction (PBJ) and a type IVa choledochal cyst. Cholecystectomy and Rouxen- Y hepatico-jejunostomy (RHJ) was performed after division of the common bile duct (CBD) and excision of the dilated segment. The details of the case are presented and the role of an abnormal PBJ in gall bladder carcinogenesis is discussed.

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